Observation of the Clinical Efficacy and Safety of Reteplase in Prehospital Thrombolysis for ST-segment Elevation Acute Myocardial Infarction_West China Medical Journal

Authors：

 WANGAn-wei ,  LIJun-feng , GAOJin-quan , LIUYao , YANShi-hua

epartment of Cardiology, the People's Hospital of Chongzhou City, Chongzhou, Sichuan 611230, P. R. China;

Corresponding?author：

LIJun-feng, Email: Ljfyisheng@sina.com

Keywords：

ST-segment elevation acute myocardial infarction; Reteplase; Prehospital thrombolysis

DOI：

10.7507/1002-0179.20140075

Video：

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Objective To observe the clinical efficacy and safety of reteplase in prehospital thrombolysis for ST-segment elevation acute myocardial infarction. Methods We retrospectively analyzed the clinical data of 62 patients with acute ST-segment elevation myocardial infarction treated in our hospital between September 2010 and December 2012.They were randomly divided into two groups:the treatment group with 22 patients given reteplase thrombolysis therapy in the prehospital ambulance and/or emergency department,and the control group with 40 patients receiving thrombolytic therapy in the hospital.Then,we compared 60-minute and 120-minute recanalization rate,the rate of complicating with various kinds of adverse reactions and the composite end-point event rate between the two groups. Results Sixty minutes and 120 minutes after thrombolysis,the clinical judgment recanalization rate in the treatment group was significantly higher than that in the control group (P<0.05).Four weeks after hospitalization,the rate of complicating with various kinds of hemorrhage,hypotension and death rate in the two groups had no statistical difference (P>0.05). Conclusion Prehospital thrombolysis treatment for ST-segment elevation acute myocardial infarction has a better clinical efficacy and is worth popularizing in basic unit hospitals.

Citation： WANGAn-wei, LIJun-feng, GAOJin-quan, LIUYao, YANShi-hua. Observation of the Clinical Efficacy and Safety of Reteplase in Prehospital Thrombolysis for ST-segment Elevation Acute Myocardial Infarction. West China Medical Journal, 2014, 29(2): 243-245. doi: 10.7507/1002-0179.20140075 Copy

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6.	European Society of Cardiology,European Resuscitation Council.The pre-hospital management of acute heart attacks.Recommendations of a task force of the European Society of Cardiology and the European Resuscitation Council[J].Eur Heart J,1998,19(8):1140-1164.
7.	Simes RJ,Topol EJ,Homes DR,et al.Link between the angiographic substudy and mortality outcomes in alarge randomized trial of myocardial reperfusion:importance of early and complete infarct artery reperfusionl[J].Circulation,1995,91(7):1923-1928.
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9.	李亞萍.急性心肌梗死的藥物溶栓治療進展[J].實用老年醫學,2000,14(2):85-87.
10.	周紅.第三代溶栓劑的作用特點及其研究現狀[J].國外醫學·心血管疾病分冊,2000,27(5):274-276.
11.	Hanson TC,Williamson D.Identifying barriers to prehospital thrombolysis in the treatment of acute myocardial infarction[J].Emerg Med J,2006,23(8):650-653.
12.	蔡繼銳,劉東亮,楊春香,等.國產瑞替普酶和進口阿替普酶對ST段抬高型心肌梗死的溶栓療效比較[J].中國心血管病研究雜志,2011,9(3):181-183.
13.	Bode C,Smalling RW,Berg G,et al.Randomized comparison of coronary thrombolysis achieved with double-bolus reteplase (recombinant plasminogen activator) and front-loaded,accelerated alteplase (recombinant tissue plasminogen activator) in patients with acute myocardial infarction[J].Circulation,1996,94(5):891-898.

1. 劉書山,胡大一,楊進剛,等.節假日對ST段抬高心肌梗死院內再灌注延遲的影響[J].中國介入心臟病學雜志,2008,16(2):91-94.
2. 黎淑珍,程玉薇.急性心肌梗死患者早期活動的探討[J].現代醫院,2007,7(3):154-155.
3. 中華醫學會心血管病分會,中華心血管病雜志編輯委員會.急性ST段抬高型心肌梗死診斷與治療指南[J].中華心血管病雜志,2010,38(8):675-690.
4. Tiandrawidjaja MC,Fu Y,Westerhout CM,et al.Resolution of ST-segment depression:a new prognestie marker in ST-segment elevation myocardial infarction[J].Eur Heart J,2010,31(5):573-581.
5. 邵耕.現代冠心病[M].北京:北京醫科大學,中國協和醫科大學聯合出版社,1994:331-338.
6. European Society of Cardiology,European Resuscitation Council.The pre-hospital management of acute heart attacks.Recommendations of a task force of the European Society of Cardiology and the European Resuscitation Council[J].Eur Heart J,1998,19(8):1140-1164.
7. Simes RJ,Topol EJ,Homes DR,et al.Link between the angiographic substudy and mortality outcomes in alarge randomized trial of myocardial reperfusion:importance of early and complete infarct artery reperfusionl[J].Circulation,1995,91(7):1923-1928.
8. Di Mario,Dudek D,Piscione F,et al.Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the combined abciximab reteplase stent study in acute myocardial infarction (CARESS-in-AMI):an open,prospective,randomized,multicentre trial[J].Lancet,2008,371(9612):559-568.
9. 李亞萍.急性心肌梗死的藥物溶栓治療進展[J].實用老年醫學,2000,14(2):85-87.
10. 周紅.第三代溶栓劑的作用特點及其研究現狀[J].國外醫學·心血管疾病分冊,2000,27(5):274-276.
11. Hanson TC,Williamson D.Identifying barriers to prehospital thrombolysis in the treatment of acute myocardial infarction[J].Emerg Med J,2006,23(8):650-653.
12. 蔡繼銳,劉東亮,楊春香,等.國產瑞替普酶和進口阿替普酶對ST段抬高型心肌梗死的溶栓療效比較[J].中國心血管病研究雜志,2011,9(3):181-183.
13. Bode C,Smalling RW,Berg G,et al.Randomized comparison of coronary thrombolysis achieved with double-bolus reteplase (recombinant plasminogen activator) and front-loaded,accelerated alteplase (recombinant tissue plasminogen activator) in patients with acute myocardial infarction[J].Circulation,1996,94(5):891-898.

West China Medical Journal

Observation of the Clinical Efficacy and Safety of Reteplase in Prehospital Thrombolysis for ST-segment Elevation Acute Myocardial Infarction

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